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Erythrocyte, plasma, and serum antioxidant activities in untreated toxic multinodular goiter patients

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Hyperglycemia can lead to the massive production of ROS [47, 48], when excessive ROS is produced, the antioxidant enzyme system reaches saturation, and excess ROS interacts with membranes, lipids, proteins, enzymes and DNA, resulting in cell damage and dysfunction [49], especially vascular and endothelial function [50,51,52], free radicals cause oxidative damage to the kidney, and enhance fibrosis, cell proliferation, and matrix accumulation [51, 53], ROS reduces the bioavailability of nitric oxide (NO) and affects the medium filtration of glomeruli [51]

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Besides, microglial activation enhances neural death followed by brain damage by producing neurotoxic pro-inflammatory factors [30]